How to Stop Vertigo

What to do when the room starts spinning, treatments to try and four ways to prevent or ride out an attack

Orly Avitzur, M.D.

Barbara Stepko

Updated May 06, 2026

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Updated May 06, 2026

A woman sitting down with her head down on hands on her forehead

fizkes/iStock/Getty Images Plus/Getty Images

Key takeaways

Vertigo is a specific illusion of motion and can feel like spinning, rocking or swaying.
Benign paroxysmal positional vertigo is common with aging and triggered by head position changes.
Simple treatments and daily strategies can shorten attacks and reduce fall risk.

Gerard Byrne rolled over in bed one morning in 2023 and felt the room begin to spin. The sensation lasted a few minutes and went away, so he shrugged it off. Almost two weeks later, while bending over to do yard work, the feeling returned in full force, so he went to lie down.

“When I tried to get up, the whole room was spinning for about 20 seconds, like I was on an out-of-control merry-go-round, and it scared the heck out of me,” Byrne says.

That’s vertigo. About 30 percent of people over 50 will experience this unsettling sensation. Defined as “an illusion of motion,” vertigo is a very specific type of dizziness.

“If you have an illusion that you’re moving and you’re not, or have an illusion that the world is moving about you when it’s not, you are having vertigo,” says Dr. Steven Rauch, a Boston-based ear, nose and throat doctor (ENT) and otolaryngologist.

A lot of people assume that vertigo has to be a spinning sensation, says Rauch, who is affiliated with Massachusetts Eye and Ear and Massachusetts General hospitals. But it could be rocking, swaying, tumbling or a feeling of bouncing up, as if you were on a pogo stick.

Causes of vertigo

Many things can bring on vertigo, including inner ear infections, migraines, Ménière’s disease and even some medications, including those used to treat high blood pressure or anxiety.

One of the most common causes, as Byrne, 67, discovered after a doctor visit, is an inner-ear condition with a tongue twister of a name: benign paroxysmal positional vertigo. BPPV can affect people of all ages, but it’s most common in adults over age 50. About half of all people in this age range experience at least one episode of BPPV in their lifetime, according to the Cleveland Clinic.

Along with the “Whoa, what the heck …?” sensation, people may experience lightheadedness and a wonky sense of balance. Queasiness and vomiting may be part of the package.

BPPV occurs when tiny calcium carbonate crystals, which normally reside in an inner-ear organ called the utricle and help you keep your balance, break loose and travel into the semicircular canals of the inner ear. This may be part of the normal aging process.

“BPPV is a degenerative change in the inner ear,” Rauch says. “A degenerative utricle will shed crystals from time to time, like shingles falling off the side of an old house.”

Sometimes a bump on the head dislodges the crystals.

“BPPV is positionally triggered,” says Kim Bell, a San Diego–based doctor of physical therapy who specializes in vestibular rehabilitation. When you move your head in certain ways — dropping it forward to pick something up off the floor or attempting a downward-facing dog yoga pose, for instance — you can cause these crystals to move and bring about an attack of vertigo.

Seasonal allergies may play a role. “It’s interesting — there may even be a link to allergies, though we don’t know if it’s a direct relation,” says Devin McCaslin, director of audiology at the University of Michigan Medical School. “I had one patient who would come the same time every month, once a year, and it would pop up.”

Vertigo is often triggered when you’re lying down. You go to bed feeling perfectly fine, then roll over toward your bad ear to get out of bed in the morning, and wham!

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The shifting of the crystals sends a faulty signal from your inner ear to your brain about how you’re moving, which leads to that “world is spinning” sensation.

Those dizzy spells typically last less than a minute but can return anytime you pitch your head and trigger another brief, brisk spin. Some attacks can be merely annoying, says Dr. Brian McKinnon, an ENT-otolaryngologist and chair of Meritus Health’s Department of Surgery in Hagerstown, Maryland. “Others can be debilitating and dangerous, making you feel off-balance and putting you at risk for falls.”

Treatments for vertigo caused by BPPV

BPPV usually goes away on its own within weeks of the first episode, though it can last for months, as it did for Byrne, or even years. For immediate relief from those bouts of spinning, you might consider something called the canalith repositioning procedure (CRP).

The treatment — typically performed by a neurologist, vestibular rehabilitation therapist (a specially trained physical therapist), occupational therapist, audiologist or ENT — involves moving the head in a series of precise positions, allowing the crystals to migrate out of the semicircular canals back to the original vestibular organ they came from — the utricle, where they won’t cause dizziness.

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“It’s kind of like playing one of those small handheld pinball games,” Bell says, “tipping it right and left, trying to get the silver ball through the maze.”

Byrne can attest to CRP’s steadying effect. When the vertigo came back this March, he was ready to use the maneuver. “It worked immediately, and I haven’t had an attack since,” he says.

Typically, BPPV can be eliminated with one maneuver in close to 60 percent of patients over age 60. Additional treatments raise the recovery rate, though BPPV can recur periodically.

“A few of those little crystals get loose and the whole thing starts all over again,” Rauch says. If this happens, your doctor or therapist can teach you how to perform a version of CRP, like the Epley maneuver, on your own at home.

Ways to prevent and handle a BPPV attack

There are ways to prevent or ride out an attack:

1. Avoid rapid head movements

Move slowly and methodically so you don’t trigger an attack. And take time when standing up.

2. Prop up your head with a pillow

People who sleep without a pillow or a very low pillow are more prone to vertigo, says Dr. Carol A. Fosteran otolaryngologist and author of Overcoming Positional Vertigo. When you lie supine, the crystals may detach and fall into the posterior circular canal. “Sleep with your head propped up with two pillows,” she says.

Kevin Smith, a vestibular physical therapist with Clarity Rehab and Physical Therapy in Orange County, California, offers a different tack.

“People sometimes avoid bending forward or lying flat because it may cause the crystals to get loose and trigger symptoms,” he says. “While it’s OK to do this until you have the crystals repositioned, I recommend after I reposition patients that they resume all of their activities as they would normally do and not to avoid positions thinking that it will prevent the crystals from getting loose. Based on recent research, moving into those positions may actually decrease your risk of getting BPPV again.”

3. Try relaxation

“What’s making that dizzying sensation worse is oftentimes the anxiety associated with it,” Smith says. “Getting anxious is going to exacerbate symptoms.”

After experiencing an episode, take deep breaths, try to relax and let that spinning sensation run its course. “If you’re experiencing nausea, ice packs placed on the neck go a long way — but don’t leave them on there for longer than 20 minutes,” Smith says. “Cooling down your nervous system is going to help with those residual symptoms.”

4. Take vitamin D

Studies have found a link between vitamin D deficiency and recurrences of BPPV. Some researchers theorize that a diet lacking in D may create a problem with how the calcium carbonate crystals form and cause them to get displaced. What’s more, vitamin D can bolster your bones, lowering the risk that a fall will result in a fracture. If you have a D deficiency, consider taking a daily supplement.

Help with unsteadiness

Even after BPPV has been treated, some people have residual symptoms of imbalance or unsteadiness. These can usually be resolved by working with a vestibular rehabilitation therapist, as Byrne did for several weeks after the 2023 episode. The treatment helped him use specific exercises to regain his stability.

Examples of the therapy include walking on different surfaces, stepping over thresholds or maintaining balance in a stationary position. Smith offers exercises you can try at home. Perform them at your discretion, depending on your capabilities.

1. Walking head turns

Walk with your head turned to the left for three steps, then turn your head to the right for three steps. Continue for two or three minutes.

2. Unstable surface stand

Stand on a couch cushion or pillow in the corner of a wall, with a chair in front of you. Close your eyes and move your head left and right for one minute, trying to stay as still as possible. Repeat, moving your head up and down, as if nodding yes.

3. Gaze stabilization

Stand in a wall corner with a chair in front for safety, hold a sticky note with a letter written on it for a visual target, and move your head left and right (about 20 degrees to the left and 20 degrees to the right), trying to move your head faster as long as the target is in focus. Repeat, this time moving your head up and down.

Unsettling symptoms aside, BPPV is not life-threatening. “If your symptoms are centered exclusively around the ear and you want to wait it out, there’s probably no big danger in doing that,” Rauch says.

However, there are times when dizziness can point to more serious disorders, such as heart disease, stroke, diabetes, brain tumors or multiple sclerosis. If you have symptoms in any other part of your body — say, your vision has changed or you have numbness, weakness, confusion or slurred speech, it may mean you’re having a stroke. Get to the ER quickly and get it checked out by a doctor.

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Orly Avitzur, M.D., a former president of the American Academy of Neurology, is a practicing neurologist in Tarrytown, New York, and is working on a medical memoir, A Very Good Brain. She is a former medical director at Consumer Reports and a past editor in chief of Brain & Life magazine.